Teja Kapoor, MD

Using the ESSDAI as a review-of-systems guide and tracking immunologic markers can help rheumatologists prepare for targeted Sjögren’s therapies.

FcRn blockade, CD40 ligand inhibition, dual BAFF and APRIL blockade, and repurposed DMARDs are expanding treatment options in Sjögren’s disease.

Payer reliance on the ESSDAI and widespread underdiagnosis may limit access to new Sjögren’s disease therapies without better screening in practice.

Ianalumab may best suit Sjögren’s patients with systemic, B-cell-driven disease, and phase 3 safety data have so far tracked closely with placebo.

Ianalumab met its primary end point in 2 phase 3 Sjögren’s disease trials, though the modest effect size shapes which patients may benefit most.

Disease heterogeneity, irreversible glandular damage, and imperfect outcome measures help explain why Sjögren’s disease trials repeatedly fell short.